title: Internal jugular thrombophlebitis caused by dermal infection.
abstract: A 29-year-old man presented with complaints of fever and pain and itching of his left neck with atopic dermatitis and abrasion. These symptoms had persisted for two days and dullness and fever developed, but the patient did not consult a physician. On the following day, he had a fever of 40°C and redness and swelling of the left neck. He visited a local clinic and was hospitalized with suspected cellulitis. A thrombus was detected in the internal jugular vein on MRI, and he was referred to our hospital. Neck ultrasonography showed the presence of an immovable thrombus in the area from the left internal jugular vein to the left brachiocephalic peripheral vein. Blood analysis indicated a major inflammatory response and juvenile idiopathic thrombophlebitis was suspected. A filter was carefully inserted into the superior vena cava, and anticoagulant therapy and medication with antibiotics led to remission. We present this case as a rare example of a condition mimicking Lemierre syndrome that was caused by dermal infection, and we include a review of the literature.
authors.affiliation: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Japan. hisao_yskw@yahoo.co.jp
authors.forename: Hisao
authors.initials: H
authors.lastname: Yoshikawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Naohiko
authors.initials: N
authors.lastname: Nemoto
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Hara
authors.forename: Go
authors.initials: G
authors.lastname: Hashimoto
authors.forename: Takenori
authors.initials: T
authors.lastname: Otsuka
authors.forename: Masao
authors.initials: M
authors.lastname: Moroi
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sugi
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D007601:Jugular Veins; D057831:Lemierre Syndrome / Q000175:diagnosis; D008297:Male; D013207:Staphylococcal Skin Infections / Q000150:complications*; D013924:Thrombophlebitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D002981:Clindamycin; D014859:Warfarin; D015378:Imipenem